NPI | 1588688147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005370) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10112) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2022-10-07 |