| NPI | 1962732958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3015) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003504) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2021-11-22 |