| NPI | 1639540529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031181) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C07310) |
| Enumeration Date | 2015-10-17 |
| Last Update Date | 2020-05-04 |