| NPI | 1669023420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 4706) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14029) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2022-04-21 |