NPI | 1811940729 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004284) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant Medical | |
363AS0400X Physician Assistant Surgical | |
Enumeration Date | 2006-05-19 |
Last Update Date | 2018-03-17 |