NPI | 1912093790 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004525) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 1067706) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2021-04-22 |