| NPI | 1841959970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011899) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062904) | 
| Enumeration Date | 2021-12-16 | 
| Last Update Date | 2025-08-28 |