| NPI | 1952849515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008102) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MI 5601008102) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2021-04-27 |