| NPI | 1013687631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 100873) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MT MED-PAC-LIC-100873) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-11-30 |