| NPI | 1558962191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD PA105199) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2024-09-16 |