| NPI | 1316025679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004474) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-09-07 |