| NPI | 1083010284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 3739-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01755) |
| Enumeration Date | 2014-11-15 |
| Last Update Date | 2016-09-14 |