| NPI | 1447592928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3727) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6748) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2021-12-28 |