NPI | 1417972613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004766) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2021-02-02 |