| NPI | 1285681536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601004974) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085001690) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2021-03-02 |