| NPI | 1346709052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601012103) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.006970) |
| 363A00000X Physician Assistant (Licence: IL 085006970) | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2024-01-23 |