| NPI | 1174827893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 349) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: L-41918) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2021-02-04 |