| NPI | 1669531448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2086) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2001030169) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2016-04-14 |