| NPI | 1871122713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 363A00000X) |
| 363A00000X Physician Assistant (Licence: DC PA031829) | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2025-04-02 |