| NPI | 1760140982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011794) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA063089) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2021-12-05 |
| Last Update Date | 2023-11-15 |