| NPI | 1982390282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 870) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9117743) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-09-07 |