| NPI | 1932479136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007010) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004113) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2023-03-24 |