| NPI | 1831483783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0001133) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD c0003890) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2018-08-16 |