| NPI | 1932512688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 561007067) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005062) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2020-11-09 |