| NPI | 1518949759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22183) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003957) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2023-03-30 |