| NPI | 1801986914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006703) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 2326-023) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085002748) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-02-24 |