| NPI | 1669092730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5308) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008000) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085.008000) | |
| Enumeration Date | 2020-04-19 |
| Last Update Date | 2023-01-30 |