| NPI | 1366525842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601002980) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54840) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2024-05-09 |