NPI | 1205558459 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011403) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-09-14 |
Last Update Date | 2022-12-19 |