| NPI | 1932150778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 1877-023) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 1877) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2008-09-25 |