| NPI | 1477521383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 134500) |
| 363A00000X Physician Assistant (Licence: NC 104203) | |
| 363A00000X Physician Assistant (Licence: GA 005206) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2024-11-22 |