| NPI | 1922818087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2994) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA066088) |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-03-13 |