| NPI | 1205144219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008831) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401010918) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2019-12-04 |