| NPI | 1528137379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3601) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: WI 59) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2021-01-18 |