| NPI | 1750866984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5707-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02149) |
| 363A00000X Physician Assistant (Licence: MI 5601010848) | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2023-08-31 |