| NPI | 1487019238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011566) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058134) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2021-08-06 |