| NPI | 1013318559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4611) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005157) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2025-11-20 |