| NPI | 1508905662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA797) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085 002103) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2023-07-21 |