| NPI | 1396490991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.0088863) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012350) |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2025-04-01 |