| NPI | 1801131933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011514) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004567) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2024-08-19 |