| NPI | 1114988854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC 031359) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001941) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-11-24 |