| NPI | 1487309191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5878-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 112539) |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2023-08-22 |