| NPI | 1184080467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007648) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061713) |
| Enumeration Date | 2016-01-03 |
| Last Update Date | 2023-06-09 |