| NPI | 1932385762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005139) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601005139) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2022-12-16 |