| NPI | 1114516358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PR 2099) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 37770) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2024-06-06 |