NPI | 1730208547 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004457) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MI 5601004457) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2018-03-27 |