| NPI | 1013148725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1172) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC027) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2022-01-27 |