| NPI | 1740370790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052725) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C04398) |
| 363A00000X Physician Assistant (Licence: VA 0110-008348) | |
| 363A00000X Physician Assistant (Licence: DC PA200001322) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-03-07 |