| NPI | 1811203169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065290) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006771) |
| 363A00000X Physician Assistant (Licence: DE C5-0000729) | |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2024-07-09 |