| NPI | 1780623835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001553) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030267) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-01-13 |