| NPI | 1518290428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000830) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053980) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2017-11-10 |