| NPI | 1396307450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7343-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12979) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2023-08-02 |