| NPI | 1861769176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085004183) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.006861RX) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2022-03-29 |