| NPI | 1871770776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000763) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001883) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2012-10-19 |