NPI | 1538767983 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010145) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601010145) |
Enumeration Date | 2020-10-16 |
Last Update Date | 2022-11-07 |