| NPI | 1720481682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.005269) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14525) |
| 363A00000X Physician Assistant (Licence: LA 330590) | |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2024-10-30 |