| NPI | 1033703558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 24039) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 481) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2025-12-01 |