| 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 |