| NPI | 1891384848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 7878-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61264824) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2025-03-03 |