| NPI | 1508451980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5492) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2023-07-07 |