| NPI | 1033207238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C03062) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0003062) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-07-13 |