| NPI | 1245576370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000843) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003043) |
| 363A00000X Physician Assistant (Licence: PA MA055881) | |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2023-02-17 |