| NPI | 1801503669 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001984) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064116) | 
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-11-01 | 
| Last Update Date | 2025-01-15 |