| NPI | 1194325506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012834) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003088A) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2024-12-16 |