| NPI | 1063921781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4293-23) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2020-08-11 |