| NPI | 1437588977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008781) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC290) |
| 363A00000X Physician Assistant (Licence: KY PA1891) | |
| 363A00000X Physician Assistant (Licence: CT 3019) | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2024-04-04 |