| NPI | 1225256928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004665) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9108374) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2024-02-27 |