| NPI | 1275258899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011828) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE APP-000046045) |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-19 |