| NPI | 1790986917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601005209) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-002759) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2017-04-05 |