| NPI | 1477011591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009039) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 5601009039) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2020-01-23 |