| NPI | 1114195195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9160) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 560105029) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2023-09-26 |