| NPI | 1124205240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005513) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003119) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2024-06-03 |