| NPI | 1508325556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013249) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006988) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-09-28 |