| NPI | 1902144629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004618) |
| 363A00000X Physician Assistant (Licence: MS PA00259) | |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2024-10-03 |