| NPI | 1972571230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601004182) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004182) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2023-02-27 |