| NPI | 1275029589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4847) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: WI 4847-23) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2023-02-03 |