| NPI | 1316579949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2382) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WV 2382) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2024-07-23 |