| NPI | 1437192127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WV 00005) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05055) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2014-07-08 |