| NPI | 1518231141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031089) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C04694) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2015-03-19 |