NPI | 1720330285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006512) |
Enumeration Date | 2012-10-09 |
Last Update Date | 2021-10-27 |