| NPI | 1508141664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030796) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004602) |
| 363A00000X Physician Assistant (Licence: VA 0110003683) | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2016-05-27 |