| NPI | 1083706873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1220) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 9534) |
| 363A00000X Physician Assistant (Licence: WI 122023) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-08-14 |