| NPI | 1699227348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008616) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006068) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2019-11-06 |