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 |