| NPI | 1568928745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5118) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2322) |
| 363A00000X Physician Assistant (Licence: AZ 8462) | |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2024-09-10 |