| NPI | 1962098756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: DC PA200001677) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363A00000X Physician Assistant (Licence: VA 0110008875) | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2023-11-15 |