| NPI | 1023084183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WV 01204) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA895) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2010-02-17 |