| NPI | 1366075244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010796) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114921) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2021-10-26 |