NPI | 1942400775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005176) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 1898762) |
Enumeration Date | 2007-07-19 |
Last Update Date | 2025-02-25 |