| NPI | 1043301336 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C50000220) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C50000220) | 
| Enumeration Date | 2006-09-28 | 
| Last Update Date | 2025-09-11 |