| NPI | 1013799253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7572-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.010017) |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2024-12-11 |