| NPI | 1386182186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012157) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001216) |
| 363A00000X Physician Assistant (Licence: FL PA9109725) | |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2024-11-07 |