| NPI | 1861861874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007528) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1140) |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2018-12-12 |