| NPI | 1043296817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC383) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3213) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2024-05-20 |