| NPI | 1922481209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11639) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3607-023) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2024-01-03 |