| NPI | 1033528666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY PA637) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY PT637) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2023-05-24 |