| NPI | 1033698923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004537) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059923) |
| 363A00000X Physician Assistant (Licence: DE C5-0001294) | |
| 363A00000X Physician Assistant (Licence: MR4951681) | |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2019-04-04 |