| NPI | 1225605272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011451) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2023-04-07 |