| NPI | 1376053686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114702) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601008430) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2023-01-18 |