| NPI | 1548798192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010058) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801100729) |
| 363A00000X Physician Assistant (Licence: MI 1167732) | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-10-28 |