| NPI | 1720537731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801090650) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2022-10-13 |