| NPI | 1447445002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MI 5601005109) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2019-04-10 |