| NPI | 1134883788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009203) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007309RX) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2024-02-28 |