| NPI | 1639622889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005953) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3177) |
| Enumeration Date | 2016-07-24 |
| Last Update Date | 2023-06-21 |