| NPI | 1033340757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC026) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2010-10-26 |