NPI | 1720028202 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601003669) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601003669) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2020-01-14 |