| NPI | 1407883283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005561) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA 01248) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2014-08-06 |