| NPI | 1184714446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2060-023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04178) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2021-02-23 |