| NPI | 1609509157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8744-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 8744-23) |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2026-06-24 |