| NPI | 1487111894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-3856) |
| 363A00000X Physician Assistant (Licence: WV 2765) | |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2023-12-06 |