| NPI | 1053623686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5334) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-003751) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2024-06-19 |