| NPI | 1861728834 |
|---|---|
| Former Name | ELIZABETH DOROTHEA CARLISLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.003561) |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2023-11-27 |