| NPI | 1861146516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C08370) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011690) |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2024-02-29 |