| NPI | 1710450291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA0060492) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001279) |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2023-12-27 |