| NPI | 1861991978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061021) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 1140722) |
| Enumeration Date | 2018-02-04 |
| Last Update Date | 2020-05-12 |