NPI | 1598390130 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009641) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601009641) |
Enumeration Date | 2020-03-04 |
Last Update Date | 2023-11-07 |