| NPI | 1730961848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7647-023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 1215988) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2024-08-30 |