| NPI | 1649631797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031574) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06327) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2022-08-29 |