| NPI | 1710610282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 7962-23) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-07-02 |
| Last Update Date | 2024-08-16 |