| NPI | 1114026861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 868) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV WV00868) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2024-01-18 |