NPI | 1588213185 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009868) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2019-09-06 |
Last Update Date | 2023-11-27 |