Individual
RU HE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15200 SHADY GROVE RD STE 401, ROCKVILLE, MD 20850-3218
(240) 912-4683
Mailing address
10332 GRANITE CREEK LN, OAKTON, VA 22124-2766
(267) 984-3065
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA056059
PA
Other
Enumeration date
03/18/2013
Last updated
04/06/2026
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