| NPI | 1982854774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02499) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601005362) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2017-02-07 |