| NPI | 1346961240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23625) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 1177PA) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2024-02-16 |