| NPI | 1619153798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030531) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002697) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2015-05-29 |