| NPI | 1033385869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006604) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001756) |
| 363AM0700X Physician Assistant, Medical (Licence: MI 5601006604) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2025-04-21 |