| NPI | 1083147102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008955) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005054RX) |
| 363A00000X Physician Assistant (Licence: FL PA9117662) | |
| 363AS0400X Physician Assistant, Surgical (Licence: IN 10004787A) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2025-03-25 |