NPI | 1063199198 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012377) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 2082) |
Enumeration Date | 2023-06-30 |
Last Update Date | 2024-06-27 |