| NPI | 1689781981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004491) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 5601004491) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-03-03 |