| NPI | 1164115853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011731) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5601011731) |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-08-03 |