NPI | 1457040917 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011761) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-05-02 |
Last Update Date | 2023-05-26 |