| NPI | 1700273091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: DC PA031150) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MD C05821) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-10-12 |