| NPI | 1457719171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008031) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06091) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2022-12-08 |