| NPI | 1831921089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MI 5601012674) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-27 |