| NPI | 1598837627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2057-023) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005688) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2025-10-08 |