| NPI | 1801251087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54427) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007635) |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2023-08-04 |