| NPI | 1699402388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012405) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C08539) |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2024-10-28 |