| NPI | 1124400171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7674) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA181482) |
| 363A00000X Physician Assistant (Licence: IL 085005500) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2024-01-25 |