| NPI | 1083655690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10000218A) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA639) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-12-10 |