| NPI | 1437422953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA218635) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006245) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2024-03-18 |