| NPI | 1639205529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA30085) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002124) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2010-04-30 |