| NPI | 1376217125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5703-23) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: WI 5703) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2025-01-29 |