| NPI | 1598478588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011977) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064964) |
| 363A00000X Physician Assistant (Licence: PA OA006644) | |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-10-02 |