| NPI | 1770213704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7736-023) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.008889) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2024-08-19 |