| NPI | 1033448691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005614) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX pa06499) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2011-02-14 |