| NPI | 1265083992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011083) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9112591) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2023-02-14 |