| NPI | 1780780007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013356) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002286) |
| 363A00000X Physician Assistant (Licence: IN 10000741A) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2025-10-13 |