| NPI | 1205184025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2923-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002336) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2022-07-15 |