| NPI | 1518218742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 110004569) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030864) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2016-08-08 |