| NPI | 1235974577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 3101) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0010081) |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2025-09-15 |