| NPI | 1003694977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010697) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011970) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2025-03-05 |