| NPI | 1942984109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011705) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5601011705) |
| 208D00000X General Practice (Licence: MI 5601011705) | |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2024-09-23 |