NPI | 1427362391 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006094) |
363AM0700X Physician Assistant, Medical (Licence: OH 50003079) | |
Enumeration Date | 2010-08-03 |
Last Update Date | 2020-06-18 |