| NPI | 1689162406 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031732) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059716) | 
| Enumeration Date | 2018-04-26 | 
| Last Update Date | 2024-04-25 |