| NPI | 1629460183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 004253) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7562-23) |
| 363A00000X Physician Assistant (Licence: PA OA006586) | |
| 363A00000X Physician Assistant (Licence: IL 085.008370) | |
| 363A00000X Physician Assistant (Licence: NY 027353) | |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2024-04-17 |