| NPI | 1689967598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007516) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006040) |
| 363AM0700X Physician Assistant, Medical (Licence: MI 5601006040) | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2020-09-15 |