| NPI | 1720566748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012115) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009531) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2024-09-25 |