| NPI | 1518470657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006440) |
| Enumeration Date | 2017-11-12 |
| Last Update Date | 2021-07-15 |