NPI | 1033448691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005614) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX pa06499) |
Enumeration Date | 2009-12-10 |
Last Update Date | 2011-02-14 |