| NPI | 1912215021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005878) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601005878) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2024-11-20 |