| NPI | 1013168715 |
|---|---|
| Former Name | VICTORIA FAULCONER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1148) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2021-04-12 |