| NPI | 1669499281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004618 TEMP) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004618) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-03-17 |