| NPI | 1184722001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3485-023) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-002401) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-11-29 |