| NPI | 1063998094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010803) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006725) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2024-05-20 |