| NPI | 1376538330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000692) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004279) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2017-04-12 |