| NPI | 1114285137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 01555) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2013-02-04 |