| NPI | 1700533379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008958) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA200001345) |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2024-01-04 |