| NPI | 1326058660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011411) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052515) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA052515) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-07-24 |