| NPI | 1780917401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 974) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2119) |
| 363AS0400X Physician Assistant, Surgical (Licence: AK 2119) | |
| 363A00000X Physician Assistant (Licence: MI 5601005607) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MI 5601005607) | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2013-07-15 |