| NPI | 1831478361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006135) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2021-02-02 |