| NPI | 1346037447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012222) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066375) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-05-07 |