| NPI | 1417428319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001867) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9116) |
| 363A00000X Physician Assistant (Licence: 1156113) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2024-05-28 |