| NPI | 1598312662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006772) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007254) |
| 363A00000X Physician Assistant (Licence: DC PA031620) | |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2020-08-07 |