| NPI | 1942837489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2370) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004804A) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-08-07 |