| NPI | 1275078578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2151) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06402) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2020-07-22 |