NPI | 1871505644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004121) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MI 5601004121) |
Enumeration Date | 2006-08-12 |
Last Update Date | 2016-06-09 |