| NPI | 1457888976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3163) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2021-12-30 |