| NPI | 1578932620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006211) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007532) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2025-03-07 |