| NPI | 1104128735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110002141) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: DC PA030381) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2021-12-01 |