| NPI | 1457607806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008601) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004364) |
| 363A00000X Physician Assistant (Licence: AZ 5761) | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2021-12-17 |