| NPI | 1740755115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006822) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002589A) |
| 363A00000X Physician Assistant (Licence: IA 126625) | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2024-10-07 |