| NPI | 1063047637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5217-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13486) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2025-04-16 |