| NPI | 1801203229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3346-23) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 11854) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2016-12-16 |