| NPI | 1013519420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062151) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011495) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2024-01-26 |