| NPI | 1093573008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065427) |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2025-06-13 |