| NPI | 1912221102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3021-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004554) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2025-09-18 |