| NPI | 1265061899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58397) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028953) |
| 363A00000X Physician Assistant (Licence: MI 5601009917) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-08-16 |