| NPI | 1396700449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0499) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1962) |
| 363A00000X Physician Assistant (Licence: MN 9828) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2022-03-10 |