| NPI | 1659894897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4087-23) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2020-07-24 |