| NPI | 1124429196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2036) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-004078) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2023-03-20 |