| NPI | 1194433565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 101199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 10003829A) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-04-12 |