| NPI | 1487358990 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 11504) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| 363AM0700X Physician Assistant, Medical (Licence: GA 11504) | |
| Enumeration Date | 2023-03-28 | 
| Last Update Date | 2024-06-18 |