| NPI | 1568134104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 16929) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 884) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2024-04-17 |