| NPI | 1891295069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007491) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601008311) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2020-06-23 |