| NPI | 1740691518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C50000932) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MX017097) |
| 363A00000X Physician Assistant (Licence: DE C5-0000932) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA056815) | |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-06-18 |