| NPI | 1023580024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010569) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9184) |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2023-01-09 |