| NPI | 1467809251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4280) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12600) |
| 363A00000X Physician Assistant (Licence: MT 91103) | |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2022-11-17 |