| NPI | 1851027007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 23023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14137) |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-10-03 |