| NPI | 1154781128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9121041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007671) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2025-11-18 |