| NPI | 1881700276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52740) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601002726) |
| 363AM0700X Physician Assistant, Medical (Licence: MI 5601002726) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA 52740) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2025-12-18 |