| NPI | 1457900219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-009647) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009498TMP19) |
| 363A00000X Physician Assistant (Licence: MI 5601009498APP19) | |
| 363A00000X Physician Assistant (Licence: MI 5601009498) | |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2023-09-08 |