| NPI | 1255583555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002952) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 443) |
| 363A00000X Physician Assistant (Licence: PA MA053627) | |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2023-01-30 |