| NPI | 1851378715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004742) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085001898) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2013-01-22 |