| NPI | 1730445719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2741) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107216) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2023-08-02 |