| NPI | 1952013344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8022-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012593) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: CA 64316) | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-08-12 |