| NPI | 1467428359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004053) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2009-06-25 |