| NPI | 1245566892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005784) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.003643) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2019-11-13 |