| NPI | 1770908246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7726-23) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: VA 0110004790) | |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2024-12-18 |