| NPI | 1952973745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011594) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant Surgical (Licence: DE C5-0011594) | |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2021-10-03 |