| NPI | 1780293811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7301) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025322) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2023-09-07 |