| NPI | 1003958208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA30191) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7664) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2021-05-13 |