| NPI | 1639276405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2807-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR LL16417) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-03-20 |