| NPI | 1568541944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 54150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003926) |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2018-08-13 |