| NPI | 1558785154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: DE C50000921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 2999) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2025-07-01 |