| NPI | 1568992394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011616) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA Ma059190) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-02-22 |