| NPI | 1598075574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002542) |
| 363A00000X Physician Assistant (Licence: PA MA054610) | |
| 363A00000X Physician Assistant (Licence: MI 5601006324) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2020-05-29 |