| NPI | 1063071157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4756) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2022-02-08 |