| NPI | 1942218755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2125) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004125) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-11-10 |