| NPI | 1265985238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 3851) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3851-023) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2022-08-08 |