| NPI | 1225292469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3418) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10438) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2021-05-20 |