| NPI | 1821226754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA030914) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9105004) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2016-10-14 |