| NPI | 1235524133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C50001163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057271) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2017-11-16 |