| NPI | 1932619939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2103) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063861) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2023-01-17 |