| NPI | 1629757877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012170) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009651) |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2024-11-12 |