| NPI | 1275830028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2714-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60180632) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2012-11-09 |