| NPI | 1255431870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 7951) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 4213-125) |
| 101YP2500X Counselor, Professional (Licence: WI 4213-125) | |
| 363A00000X Physician Assistant (Licence: WI 7951-23) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2024-12-18 |