| NPI | 1316040660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003633) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030510) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2024-01-31 |