| NPI | 1285062307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005869) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030995) |
| 363A00000X Physician Assistant (Licence: VA 0110005058) | |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2022-03-24 |