| NPI | 1417262528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2640-33) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3203) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2016-11-16 |