| NPI | 1124624671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008952) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: OH 50.007504RX) | |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2023-01-15 |