| NPI | 1992196729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3748-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005081) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2016-10-06 |