| NPI | 1215586193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007248) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2025-02-25 |