| NPI | 1003972746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601003831) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MI 5601003831) |
| 363AM0700X Physician Assistant Medical (Licence: MI 5601003831) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2023-11-17 |