| NPI | 1720496227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000952) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000952) |
| 363AM0700X Physician Assistant, Medical (Licence: MD C0005420) | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2023-11-22 |