| NPI | 1649354242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601010462) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL pa3138) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-07-19 |