| NPI | 1780157024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011883) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006885) |
| 363A00000X Physician Assistant (Licence: WI 8233) | |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2025-06-09 |