| NPI | 1336872662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085011832) |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2026-06-25 |