| NPI | 1821379041 |
|---|---|
| Former Name | JAIME BERKLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006089) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-04476) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2022-11-10 |