| NPI | 1730079120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8480-23) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 8480-23) |
| Enumeration Date | 2025-07-07 |
| Last Update Date | 2025-10-01 |