| NPI | 1558594598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003451) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2024-06-12 |