| NPI | 1639327182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5532-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1372) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2023-04-11 |