NPI | 1083181671 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010757) |
Additional Taxonomies | 363A00000X Physician Assistant |
235Z00000X Speech-Language Pathologist, (Licence: MI 7101000951) | |
Enumeration Date | 2018-11-01 |
Last Update Date | 2022-07-22 |