| NPI | 1669928636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8212) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2024-12-31 |