| NPI | 1417330341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C05824) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001071) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2020-01-08 |