| NPI | 1497750061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0002574) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030272) |
| 363A00000X Physician Assistant (Licence: VA 0110001741) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2007-07-08 |