NPI | 1548623481 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60602146) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007684) |
Enumeration Date | 2016-03-29 |
Last Update Date | 2016-03-29 |