| NPI | 1083350623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 24148) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1270-PA) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2024-10-26 |