| NPI | 1114969003 |
|---|---|
| Former Name | ELISABETH VANWYKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22308) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002670) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2012-09-10 |