| NPI | 1467961599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006352) |
| 363AM0700X Physician Assistant, Medical (Licence: WI 4258-23) | |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2023-03-10 |