| NPI | 1215701594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012125) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009681) |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2024-12-17 |