| NPI | 1437678992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006243) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009905) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2024-04-16 |