| NPI | 1992005029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003731) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003854) |
| 363A00000X Physician Assistant (Licence: MI 5601006946) | |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2022-01-25 |