| NPI | 1407485675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011793) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007054) |
| 363A00000X Physician Assistant (Licence: DC PA031850) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-11-10 |