| NPI | 1154988608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009441) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009441APP19) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2025-11-04 |