| NPI | 1013493907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4461) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 446123) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2023-05-23 |