| NPI | 1952666554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2980-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-010018) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2024-01-31 |