| NPI | 1053681221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006267) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MI L2109519) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2023-06-27 |