| NPI | 1316374531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008378) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1965) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2020-01-24 |