| NPI | 1811354798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009857) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019513-1) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2023-11-09 |