NPI | 1770379067 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601013132) |
Enumeration Date | 2025-04-15 |
Last Update Date | 2025-05-25 |