| NPI | 1508638487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI C09160) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 1215954) |
| 207P00000X Emergency Medicine (Licence: MD 1215954) | |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-12-01 |