| NPI | 1861419384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085001824) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA61352) |
| 363A00000X Physician Assistant (Licence: NY 028637) | |
| 363A00000X Physician Assistant (Licence: AZ 9073) | |
| 363A00000X Physician Assistant (Licence: VA 0110011223) | |
| 363A00000X Physician Assistant (Licence: WI 716223) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-09-11 |