| NPI | 1154990638 |
|---|---|
| Former Name | MICHAEL PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY TL8856) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-07-30 |