| NPI | 1407890809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1978) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 088762) |
| 363AM0700X Physician Assistant, Medical (Licence: WI 1978) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-02-16 |