| NPI | 1336500404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058147) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001053) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2026-06-18 |