| NPI | 1306489786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031643) |
| 363AS0400X Physician Assistant, Surgical (Licence: DC PA031643) | |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2023-01-19 |