| NPI | 1225040785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 1656) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00364) |
| 363A00000X Physician Assistant (Licence: MD C0003717) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-09-11 |