| NPI | 1992098065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601005961) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2019-09-18 |