| NPI | 1073182879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4554) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010465) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2022-12-27 |