| NPI | 1497087597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C07173) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054229) |
| 363A00000X Physician Assistant (Licence: PA OA002472) | |
| 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001087) | |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2020-12-15 |