| NPI | 1619038270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002487) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1871) |
| 363AM0700X Physician Assistant, Medical (Licence: DC PA030418) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2023-04-07 |