| NPI | 1467899161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108551) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006667) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2022-07-21 |