| NPI | 1568411841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601006720) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY PA653) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2025-01-14 |