| NPI | 1871965129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5513) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2022-10-25 |