| NPI | 1194186536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058892) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001052) |
| Enumeration Date | 2016-03-13 |
| Last Update Date | 2017-04-05 |