| NPI | 1699786806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 7210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085000314) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2023-05-23 |