| NPI | 1194810564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA246) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0001655) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |