| NPI | 1558414946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 1783) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002685) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2023-09-05 |