| NPI | 1174216006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011792) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2024-03-13 |