| NPI | 1962700385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003584) |
| 363A00000X Physician Assistant (Licence: DC PA030750) | |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2014-06-09 |