| NPI | 1548616469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009981) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2022-11-30 |