NPI | 1700248176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601007710) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601007710) |
Enumeration Date | 2016-03-24 |
Last Update Date | 2022-04-04 |