| NPI | 1912942285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2375-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-002154) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2022-07-21 |