| NPI | 1699101055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003932) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001137) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2019-10-25 |