| NPI | 1295375814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013265) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115120) |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2025-12-10 |