| NPI | 1366803488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8728-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 126726) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA10507) | |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2026-03-30 |