| NPI | 1396455630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009405) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003889A) |
| 363A00000X Physician Assistant (Licence: WI 7205-23) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2023-01-09 |