| NPI | 1285299743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060443) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011987) |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA004729) | |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2023-11-15 |