| NPI | 1851763635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6251) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601011525) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2024-12-13 |