| NPI | 1023443181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000980) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056360) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2021-07-02 |