| NPI | 1124624671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008952) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007504RX) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2025-09-03 |