| NPI | 1245996602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5687) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2024-06-20 |