| NPI | 1528582335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006410RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.009422) |
| 363A00000X Physician Assistant (Licence: IN 10003993A) | |
| 363A00000X Physician Assistant (Licence: MI 5601011449) | |
| 363A00000X Physician Assistant (Licence: NY 021326) | |
| 363A00000X Physician Assistant (Licence: PA MA064545) | |
| 363A00000X Physician Assistant (Licence: WI 7391-23) | |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2024-04-25 |