| NPI | 1861444093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601002851) |
| 363A00000X Physician Assistant (Licence: IA 082929) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-03-17 |