| NPI | 1770332918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 8029) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-11-12 |