NPI | 1386354991 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011490) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5601011490) |
363AM0700X Physician Assistant, Medical (Licence: MI 5601011490) | |
Enumeration Date | 2022-12-05 |
Last Update Date | 2024-01-19 |