| NPI | 1588815195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053679) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001058) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2022-09-29 |