| NPI | 1023145018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004705) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50 002219) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2016-12-16 |