| NPI | 1366670309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 2745) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085003475) |
| 363AM0700X Physician Assistant, Medical (Licence: MS PA00601) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2025-06-03 |