| NPI | 1821624925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5107-23) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: WI 5107) |
| 363A00000X Physician Assistant (Licence: WI 5107) | |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2022-11-08 |