| NPI | 1659503928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002046) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030379) |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2010-08-19 |