| NPI | 1861642910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 168382) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005384) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2022-10-11 |