| NPI | 1619442977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-009291) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005734RX) |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2022-12-21 |