NPI | 1023580024 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010569) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9184) |
Enumeration Date | 2019-01-02 |
Last Update Date | 2023-01-09 |