| NPI | 1285021121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7202-023) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 52375) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2023-06-23 |