| NPI | 1487263059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031815) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007300) |
| 363A00000X Physician Assistant (Licence: MD C0007594) | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2022-09-29 |