| NPI | 1033776109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61438) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009184) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2022-11-21 |