| NPI | 1356742019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3726-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5090) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2021-03-31 |