| NPI | 1659974517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011588) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062717) |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2021-11-02 |