| NPI | 1871006072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7339) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006360) |
| 363A00000X Physician Assistant (Licence: IN 10002976A) | |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2023-11-15 |