| NPI | 1316362817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006945) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2023-01-10 |