| NPI | 1003239500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006884) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2108) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2020-09-28 |