| NPI | 1417414954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WI 5282) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5282) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2024-01-25 |