| NPI | 1083083984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2052) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC420) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2019-03-22 |