| NPI | 1336343540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010654) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002968) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2021-11-09 |