| NPI | 1417612326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5604-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1173677) |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-11-19 |