| NPI | 1528712411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23930) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 000242) |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2024-07-03 |