NPI | 1881879781 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 19555) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005995) |
Enumeration Date | 2008-01-09 |
Last Update Date | 2016-09-11 |