| NPI | 1598310849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7305) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-007148) |
| 363A00000X Physician Assistant (Licence: IL 085-007148) | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2026-08-17 |