| NPI | 1427619170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012134) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 113488) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2024-02-06 |