| NPI | 1992121057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004902) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4266) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9107788) | |
| 363A00000X Physician Assistant (Licence: FL PA9107788) | |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2024-09-11 |