| NPI | 1952643645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005219) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601005219) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2018-07-09 |