| NPI | 1619108370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01422) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA067793) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2026-06-09 |