| NPI | 1730919242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8204) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 8204) |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-11-21 |