| NPI | 1245447481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA242) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0001891) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |