| NPI | 1629321914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005099) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006509) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2014-08-20 |