| NPI | 1598466534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 24238) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1399) |
| Enumeration Date | 2023-03-16 |
| Last Update Date | 2025-03-17 |