NPI | 1083812622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005013) |
Additional Taxonomies | 133V00000X Dietitian, Registered |
Enumeration Date | 2007-07-05 |
Last Update Date | 2012-11-13 |