| NPI | 1184807158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2208) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003081) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2023-11-14 |