| NPI | 1598341273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009138) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC084) |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA2841) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY TC084) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KY PA2841) | |
| 363A00000X Physician Assistant (Licence: KY PA2841) | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2022-11-28 |