| NPI | 1679239206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: DC PA200001327) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008232) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2024-07-02 |