| NPI | 1083458525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 3153) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA065559) |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2026-02-10 |