| NPI | 1144995697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601012432) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60068) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 60068) | |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2025-02-13 |