| NPI | 1033883004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008578) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010677) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2022-04-20 |