| NPI | 1013647015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011788) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA-067102) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2026-03-12 |