| NPI | 1376289033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2644) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WV TEMP2965) | |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2023-07-19 |