| NPI | 1710516877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011726) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061479) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA061479) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2022-11-28 |