| NPI | 1174616403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003017) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601004862) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2015-01-08 |