| NPI | 1649396771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031351) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002390) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2021-04-23 |