| NPI | 1669280384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5601012938APP24) |
| Enumeration Date | 2024-12-27 |
| Last Update Date | 2025-01-14 |