| NPI | 1962780668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012103) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C0009585) |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA002699) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA055022) | |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2024-09-18 |