| NPI | 1649855974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8838-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008525) |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2026-03-20 |