| NPI | 1144981077 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011819) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011819) | 
| Enumeration Date | 2022-01-03 | 
| Last Update Date | 2024-10-03 |