| NPI | 1952950347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001012273) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009758) |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2023-02-08 |