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 |