| NPI | 1093220535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059634) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001368) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2021-04-08 |