| NPI | 1033533302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1878) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC259) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2016-04-05 |