| NPI | 1801377197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5698-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060035) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2023-11-02 |