| NPI | 1316042211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011425) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057401) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2021-08-04 |