| NPI | 1023153418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104887) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1000) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2013-05-28 |