| NPI | 1891464442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7666) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MN 13879) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-07-18 |