| NPI | 1386040046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008981) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10001768A) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2022-10-04 |