| NPI | 1184969586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4303) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004522) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2019-01-22 |