| NPI | 1750841151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011985) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060539) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-10-23 |