| NPI | 1326170952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601002662) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001898) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2010-05-05 |