| NPI | 1124573530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115447) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2166) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2022-05-23 |