| NPI | 1013481753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031525) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 00110006450) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |