| NPI | 1215546791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009573) |
| Additional Taxonomies | 243U00000X Radiology Practitioner Assistant (Licence: MI 5601009573) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2023-01-10 |