| NPI | 1386998102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA037073) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005293) |
| 363A00000X Physician Assistant (Licence: MD C0004926) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2016-10-14 |