| NPI | 1275504243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01792) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA050618) |
| 363A00000X Physician Assistant (Licence: MI MG134090) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2024-09-20 |