| NPI | 1902815038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA052415) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000533) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2023-01-03 |