| NPI | 1710404223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011541) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059211) |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2021-08-03 |