| NPI | 1568128239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008573) |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2025-03-27 |