| NPI | 1467231605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011990) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.008442RX) |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2024-12-16 |