NPI | 1063848992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006842) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006842) |
Enumeration Date | 2013-09-24 |
Last Update Date | 2019-03-18 |