| NPI | 1659725976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109562) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9109562) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2025-07-07 |