| NPI | 1982278628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012181) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12175) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-08-26 |