| NPI | 1184276305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 477623) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4776-23) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2024-01-02 |