| NPI | 1457724965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007847) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 1001984A) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2020-05-07 |