NPI | 1598917957 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105586) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005424) |
Enumeration Date | 2008-10-16 |
Last Update Date | 2021-09-15 |