| NPI | 1851982433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010611) |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2022-01-14 |