| NPI | 1487071536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007290) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004436) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2015-12-08 |