NPI | 1801894571 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004187) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601004187) |
363AS0400X Physician Assistant, Surgical (Licence: MI 5601004187) | |
Enumeration Date | 2005-07-07 |
Last Update Date | 2014-10-15 |