NPI | 1760951321 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010978) |
Enumeration Date | 2018-11-13 |
Last Update Date | 2022-05-25 |