| NPI | 1073745808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006860) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 363AM0700X Physician Assistant, Medical (Licence: MI 5601006860) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2023-12-14 |