| NPI | 1619083102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085000996) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA752) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-08-26 |