| NPI | 1932976974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011869) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601011869APP23) |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2025-09-29 |