| NPI | 1427648922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010631) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2024-01-31 |