| NPI | 1215410402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001475) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008622) |
| 363A00000X Physician Assistant (Licence: MD C07009) | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2022-06-23 |