| NPI | 1265532782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065448) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI PT004145) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2024-05-28 |