| NPI | 1073980728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS 00337) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2047) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2022-07-21 |