| NPI | 1508154956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001678) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9106033) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2024-09-01 |