| NPI | 1598746513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 1874023) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 10917) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2023-12-05 |