NPI | 1134140494 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA993) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: KY PA993) |
363AS0400X Physician Assistant Surgical (Licence: KY PA993) | |
Enumeration Date | 2006-07-22 |
Last Update Date | 2020-07-29 |