| NPI | 1790206274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011878) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA004186) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA059129) | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2024-12-04 |