| NPI | 1134433311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9109809) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WV 01460) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2022-07-21 |