| NPI | 1013458520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0001116) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058883) |
| 363A00000X Physician Assistant (Licence: MD C0007867) | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2025-03-19 |