| NPI | 1427192442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC pa131) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002555) |
| 363AS0400X Physician Assistant, Surgical (Licence: DC PA131) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2024-04-08 |