| NPI | 1700900834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006720) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030477) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-03-06 |