| NPI | 1861009482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3464) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085009409) |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2024-12-13 |