| NPI | 1366054116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5115-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007939) |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2023-10-06 |