| NPI | 1386095040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031265) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 1130579) |
| 363A00000X Physician Assistant (Licence: DC PA031265) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2022-10-12 |