| NPI | 1679169890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-008312) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001697) |
| Enumeration Date | 2020-12-13 |
| Last Update Date | 2023-06-07 |