| NPI | 1558091058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.009214) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2023043565) |
| 363A00000X Physician Assistant (Licence: FL PA9116770) | |
| 363A00000X Physician Assistant (Licence: NE 3019) | |
| 363A00000X Physician Assistant (Licence: IN 10004606A) | |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2024-10-26 |