| NPI | 1225022957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601002937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108632) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2018-10-02 |