NPI | 1083231252 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010335) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-07-02 |
Last Update Date | 2021-05-06 |