| NPI | 1003253824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA65523) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006674) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2025-09-09 |