| NPI | 1265597538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004651) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030279) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2021-02-15 |