| NPI | 1376686006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2074) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008980) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2024-01-24 |