| NPI | 1396712873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601003337) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4704131882) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2022-07-21 |