| NPI | 1245208818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003292) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2023-05-10 |