| NPI | 1336776657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5841-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 101673) |
| 363AM0700X Physician Assistant, Medical (Licence: IA 101673) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2023-11-13 |