| NPI | 1841692373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007093) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2022-01-07 |