| NPI | 1104973965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001639) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0001823) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2026-01-06 |