| NPI | 1598917957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105586) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005424) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2021-09-15 |