| NPI | 1336128347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C50000464) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002960) |
| 363AS0400X Physician Assistant, Surgical (Licence: DE C50000464) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2008-08-18 |