| NPI | 1972261220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011697) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063275) |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2022-11-28 |