| NPI | 1942232160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06656) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004436) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-08-15 |