| NPI | 1134643372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012073) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5422) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2024-07-25 |