| NPI | 1508913047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007247) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2025-06-02 |