| NPI | 1881065019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007860) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 2293) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2025-11-25 |