| NPI | 1235722976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 3061) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-02-13 |
| Last Update Date | 2025-08-13 |