| NPI | 1013461581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58848) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2023-10-13 |