NPI | 1518261403 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI PERMANENT5601001159) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI L1610148) |
Enumeration Date | 2011-01-06 |
Last Update Date | 2011-01-06 |