| NPI | 1215631080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2832) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA16690) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2025-03-25 |