| NPI | 1124531793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2308) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY PA2308) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2020-10-27 |