| NPI | 1831290683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-499) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1340) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2025-07-08 |