| NPI | 1205893773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA051963) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0012094) |
| 363A00000X Physician Assistant (Licence: MD C0009539) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2024-09-24 |