| NPI | 1427362391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006094) |
| 363AM0700X Physician Assistant, Medical (Licence: OH 50003079) | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2020-06-18 |