| NPI | 1184007601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5008) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2022-06-22 |