| NPI | 1922605120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010086) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MI 5601010086APP20) | |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2024-12-20 |