| NPI | 1437547346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004767) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01856) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2022-01-25 |