| NPI | 1831566595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601008147) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108901) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2025-04-01 |