| NPI | 1225531635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4318) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3501) |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-03-22 |