| NPI | 1225658768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8375-023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007504) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2026-01-30 |