| NPI | 1568999464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008238) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2021-12-27 |