| NPI | 1780081950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 4301067273) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1562) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2025-02-28 |