| NPI | 1811905508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007902) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301008248) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2022-07-21 |