| NPI | 1487804076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04052) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01370) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2026-06-19 |