| NPI | 1376913574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005658) |
| 363A00000X Physician Assistant (Licence: CO PA.0006705) | |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2023-10-06 |