| NPI | 1528465937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007226) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005325) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2018-10-04 |