| NPI | 1679163984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MI 5601010568) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2025-04-21 |