| NPI | 1811657737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008713) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5501-23) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2021-12-20 |