| NPI | 1194171009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 3002) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601007739) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-07-27 |