| NPI | 1851939078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA 190962488) |
| 363A00000X Physician Assistant (Licence: PA 190962286) | |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2021-04-21 |