| NPI | 1811741101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012805) |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-11-27 |