| NPI | 1083915052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007402) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105695) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2019-09-20 |