| NPI | 1144850041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7856-23) |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2025-08-26 |