| NPI | 1033465679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 11202) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2023-06-30 |