| NPI | 1952379638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004214) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103252) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2025-06-23 |