| NPI | 1053127464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2958) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9119381) |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2025-07-02 |