NPI | 1417235441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012287) |
Enumeration Date | 2011-07-25 |
Last Update Date | 2024-04-22 |