| NPI | 1588067557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 121704) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 11941) |
| 363A00000X Physician Assistant (Licence: WI 3441-23) | |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2023-12-15 |