| NPI | 1356992341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007835) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 50.006108RX) |
| 363A00000X Physician Assistant (Licence: OH 50.006108RX) | |
| Enumeration Date | 2019-09-22 |
| Last Update Date | 2021-06-15 |