| NPI | 1376153916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0007619) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011657) |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2022-04-25 |