| NPI | 1639344054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005132) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601005132) |
| Enumeration Date | 2008-04-27 |
| Last Update Date | 2016-02-26 |