| NPI | 1184052508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA54017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006710) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2018-12-26 |