| NPI | 1699027128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006905) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030884) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2019-12-19 |