| NPI | 1225522436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601008710) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2019-08-28 |