NPI | 1518949759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22183) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003957) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2023-03-30 |