| NPI | 1760530521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WV 718) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.002445) |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50.002445) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2024-10-11 |