| NPI | 1922180223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004884) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009859) |
| 363A00000X Physician Assistant (Licence: PA MA064054) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2024-02-29 |