| NPI | 1619968906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002514) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030369) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2022-04-06 |