| NPI | 1366201162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085010418) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.008612RX) |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2025-03-18 |