| NPI | 1316275464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003113) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030641) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2012-10-08 |