| NPI | 1659599447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107164) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004146) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-09-27 |