| NPI | 1518426139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060546) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060546) |
| 363AM0700X Physician Assistant, Medical (Licence: DE C5-0012139) | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2025-05-06 |