| NPI | 1154670271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030868) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C08735) |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2022-12-27 |