| NPI | 1407482615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085010544) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010338) |
| 363A00000X Physician Assistant (Licence: NC 0010-11026) | |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2024-12-26 |