| NPI | 1629726021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-008417) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA200001371) |
| 363A00000X Physician Assistant (Licence: MD C0008353) | |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-12-04 |