| NPI | 1396256376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WV 3005) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005225RX) |
| 363A00000X Physician Assistant (Licence: FL PA9114801) | |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2025-09-02 |