| NPI | 1548709181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005681) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 2131) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2021-02-27 |