| NPI | 1962470922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA pa19525) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003509) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2014-11-18 |