| NPI | 1003118043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2720-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C04408) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2015-05-19 |