| NPI | 1831681709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008692) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601008692) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-08-25 |