| NPI | 1144521170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 1144521170) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA001242) |
| 363A00000X Physician Assistant (Licence: WA PA60229706) | |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2017-02-01 |