| NPI | 1932445038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5471-23) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 1151) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2021-10-01 |