| NPI | 1649165093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA67604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012898) |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2026-02-07 |