| NPI | 1063722460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030718) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2021-09-02 |