| NPI | 1437241155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01544) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0111121) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2022-04-08 |