| NPI | 1730578535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2685) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005377) |
| 363A00000X Physician Assistant (Licence: MO 2023006254) | |
| 363AS0400X Physician Assistant Surgical (Licence: IL 085005377) | |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2023-06-15 |