| NPI | 1962098756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001677) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008875) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2026-07-27 |