| NPI | 1710410600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031345) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005726) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |