| NPI | 1255672135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA030899) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004917) |
| Enumeration Date | 2013-03-02 |
| Last Update Date | 2013-03-02 |