| NPI | 1497749766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01126) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 340) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2008-03-27 |