| NPI | 1730575481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007438) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2015009432) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2016-11-22 |