| NPI | 1588893242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007127) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801085900) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2022-09-06 |