| NPI | 1306812888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2236) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 9936) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2024-04-17 |