| NPI | 1669022307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601009532) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5601009532APP19) |
| Enumeration Date | 2019-09-15 |
| Last Update Date | 2022-09-06 |