| NPI | 1891482659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 24235) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 1643) |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2025-01-22 |