| NPI | 1992069140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2928) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004665) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2022-04-14 |