| NPI | 1235118662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC325) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002564) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-03-10 |