NPI | 1881700276 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52740) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601002726) |
363AM0700X Physician Assistant, Medical (Licence: MI 5601002726) | |
363AM0700X Physician Assistant, Medical (Licence: CA 52740) | |
Enumeration Date | 2006-08-21 |
Last Update Date | 2015-10-01 |