| NPI | 1609954585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MI 5601009932) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA10005245) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-04-28 |