| NPI | 1700160876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601006798) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006198) |
| 363AM0700X Physician Assistant, Medical (Licence: MI 5601006198) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MI 5601006198) | |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2017-05-18 |