NPI | 1457476129 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601002219) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601002219) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2023-07-31 |