| NPI | 1053070144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008278) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011682) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2022-02-25 |