| NPI | 1184134967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5309) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012206) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2024-09-04 |