NPI | 1003883067 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108805) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601001892) |
Enumeration Date | 2006-03-08 |
Last Update Date | 2018-09-20 |