| NPI | 1043393150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601003370) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OK 1046093) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-05-23 |