| NPI | 1790137081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5066-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001006534) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2021-03-09 |