| NPI | 1982407771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013435) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 1982407771) |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2026-08-04 |