| NPI | 1386854628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007170) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801070804) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-12-05 |