| NPI | 1194490300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.010177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062702) |
| 363A00000X Physician Assistant (Licence: OH 50.007742RX) | |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2024-03-04 |