| NPI | 1528536133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14124) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009606) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2024-04-17 |