| NPI | 1417232125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-006215) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601011010) |
| 363A00000X Physician Assistant (Licence: PA MA065297) | |
| 363A00000X Physician Assistant (Licence: NY 027823) | |
| 363A00000X Physician Assistant (Licence: OH 50.007875rx) | |
| 363A00000X Physician Assistant (Licence: FL PAT9106199) | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2024-04-30 |