| NPI | 1184817975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030915) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052474) |
| 363A00000X Physician Assistant (Licence: MD C04526) | |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2014-10-22 |