| NPI | 1073123212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003654A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2686) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2024-07-08 |