NPI | 1801012463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004305) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004305) |
363AS0400X Physician Assistant, Surgical (Licence: MI 5601004305) | |
Enumeration Date | 2007-04-18 |
Last Update Date | 2007-07-08 |