NPI | 1033195516 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601001739) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601001739) |
Enumeration Date | 2005-12-16 |
Last Update Date | 2009-02-25 |