| NPI | 1245711217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5769-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006720) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085.006720) | |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085.006720) | |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2023-05-04 |