| NPI | 1154081008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011649) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2021-12-20 |