| NPI | 1215261987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2467-023) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 2467-023) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2009-09-28 |