| NPI | 1902788375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012312) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0010058) |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2025-07-24 |