| NPI | 1124573530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-15078) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-15078) |
| 363A00000X Physician Assistant (Licence: KY PA2166) | |
| 363A00000X Physician Assistant (Licence: FL PA9115447) | |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2025-06-05 |