| NPI | 1124169222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009223) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002177) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2021-02-17 |