| NPI | 1013366905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002591A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY TC483) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2021-03-02 |