| NPI | 1083267082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0001327) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009380) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2024-06-25 |