| NPI | 1316318389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6175) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2022-04-18 |