| NPI | 1831802339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7178) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI PAR-0000015390) |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2024-05-28 |