| NPI | 1285783969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1298) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 079554) |
| 363A00000X Physician Assistant (Licence: WI 2644-023) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-12-31 |