| NPI | 1851567093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 1344) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 1344) |
| 363A00000X Physician Assistant (Licence: GA 007049) | |
| 363A00000X Physician Assistant (Licence: WV 415) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2023-01-28 |